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Does the unified protocol really change neuroticism? Results from a randomized trial

Published online by Cambridge University Press:  21 April 2020

Shannon Sauer-Zavala Open the ORCID record for Shannon Sauer-Zavala [Opens in a new window] ,
Jay C. Fournier Open the ORCID record for Jay C. Fournier [Opens in a new window] ,
Stephanie Jarvi Steele Open the ORCID record for Stephanie Jarvi Steele [Opens in a new window] ,
Brittany K. Woods ,
Mengxing Wang ,
Todd J. Farchione  and
David H. Barlow
Shannon Sauer-Zavala*
Affiliation:
Department of Psychology, University of Kentucky, Lexington, KY 40506, USA
Jay C. Fournier
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Stephanie Jarvi Steele
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
Brittany K. Woods
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
Mengxing Wang
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
Todd J. Farchione
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
David H. Barlow
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
*
Author for correspondence: Shannon Sauer-Zavala, E-mail: ssz@uky.edu
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Abstract

Background

Neuroticism is associated with the onset and maintenance of a number of mental health conditions, as well as a number of deleterious outcomes (e.g. physical health problems, higher divorce rates, lost productivity, and increased treatment seeking); thus, the consideration of whether this trait can be addressed in treatment is warranted. To date, outcome research has yielded mixed results regarding neuroticism's responsiveness to treatment, perhaps due to the fact that study interventions are typically designed to target disorder symptoms rather than neuroticism itself. The purpose of the current study was to explore whether a course of treatment with the unified protocol (UP), a transdiagnostic intervention that was explicitly developed to target neuroticism, results in greater reductions in neuroticism compared to gold-standard, symptom focused cognitive behavioral therapy (CBT) protocols and a waitlist (WL) control condition.

Method

Patients with principal anxiety disorders (N = 223) were included in this study. They completed a validated self-report measure of neuroticism, as well as clinician-rated measures of psychological symptoms.

Results

At week 16, participants in the UP condition exhibited significantly lower levels of neuroticism than participants in the symptom-focused CBT (t(218) = −2.17, p = 0.03, d = −0.32) and WL conditions(t(207) = −2.33, p = 0.02, d = −0.43), and these group differences remained after controlling for simultaneous fluctuations in depression and anxiety symptoms.

Conclusions

Treatment effects on neuroticism may be most robust when this trait is explicitly targeted.

Keywords

Cognitive-behavioral therapyneuroticismtransdiagnosticunified protocol
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 14 , October 2021 , pp. 2378 - 2387
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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Footnotes

*

First authorship is shared equally.

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